Major Dual Choice changes for 2006
Dual Choice Booklets
Health Insurance Changes
Each year employees enrolled in one
of the State Group Health Insurance plans have the opportunity to
change from one health insurance carrier to another, or to add
eligible family members who are not presently covered. This
year, the Dual Choice enrollment is from October 9 through October
27. The effective date of any change is January 1, 2007.
To help employees
assess their current health care plan and determine the need to make
changes in coverage, the Office of Human Resources is providing the
Is my plan still available? If not, have I selected a new plan
and completed the application?
Is my physician, clinic, or hospital still affiliated with my
Are there sufficient providers, including specialists,
Have benefits changed with my plan?
Has the premium for my plan changed?
Does my plan include dental
Am I satisfied with my plan?
Do I want to change from single to family coverage for 2007?
Have I reviewed the Dual Choice Booklet (booklets being sent out
week of October 9)?
Have I checked which Tier my plan is in for 2007?
Am I changing plans? If so, have I submitted an
application to Human Resources?
Applications are due in the Human Resources office no later than
4:30 p.m. on Friday, October 27, 2006.
What are the major Dual Choice changes?
Security Health Plan is back.
Security provides coverage in Eau Claire, Chippewa, Clark,
and Pepin counties, as well as coverage in other counties
outside our local region. They are in Tier 1. Check
out their providers on page G-35 of the Dual Choice booklet, or
www.securityhealth.org under "visitors."
Standard Plan and Standard
Maintenance Plan (SMP) will be administered by Wisconsin
Physician Service (WPS) again this year. If you wish to
remain with the Standard Plan or SMP, you are not required to
complete a new application. Check the provider list at
(Please note that SMP is not available in most counties, but is
still available in Pierce and Pepin counties.)
Pharmacy Benefit Manager.
Again in 2007 there will be one drug formulary for all state
employees. Please refer to
http://www.navitushealth.com for a complete drug formulary.
- Premium Rates for 2007
For calendar year 2007 employee share for premiums will be as
| Single Coverage
amounts ($5.00, $15.00, and $35.00) will remain the same in 2007.
However, the out-of-pocket maximum will increase to $320.00 per
individual, and $640.00 per family for most plans. (Don't
forget that the Employee Reimbursement Account allows prescription
co-pays as a medical reimbursement item.) Standard Plan
out-of-pocket maximums remain at $1,000.00 per individual and $2,000.00 per family.
will be sent to all currently covered
employees during the week of October 9th. The booklet contains
important information about changes in uniform benefits, prescription drug
coverage, and provider network changes. Booklets will be distributed
through campus mail. Anyone with questions about insurance coverage or
anyone considering a change is encouraged to meet with representatives at
the Benefits Fair scheduled for October 18, 2006.
A complete list of notable plan and program
changes may be found in the
“It’s Your Choice” 2007
Dual Choice Booklet at
Other Enrollment Information
**New in 2007!**
Spectera Vision Insurance
The Spectera Vision Plan provides
partial payment to help you offset the costs of annual eye exams
(which are also covered under Uniform Benefits), frames, lenses, and
contact lenses. It also provides a discounted refractive eye
surgery at select locations.
participate, you must be eligible for immediate or future employer contribution
to the health insurance program. This includes the following
employees and their dependents:
Domestic partners and their
children are eligible under this plan.
Rehired annuitants receiving a
Wisconsin Retirement System annuity are not eligible for this
enrollment for Spectera Vision insurance is October 9 -
November 17, 2006. Applications must be submitted to
the Human Resources office by 4:30 p.m. on Friday, November 17,
2006. Coverage will be effective on January 1, 2007.
Premiums will be deducted from your paycheck on a pretax basis.
Spectera Vision Insurance information will be sent to all
eligible employees through campus mail.
ERA (Employee Reimbursement Account)
enrollment is scheduled from October 9 through November 17, 2006.
Information is being sent through campus mail.
The booklet explains online enrollment procedures.
Medical and child care expenses for services provided through March 15, 2007, may
with funds remaining from 2006 plan year. However, any unused
amounts from the prior plan year that are not used for expenses
incurred by March 15 remain subject to the "use it or lose it" rule
and will be forfeited.
The deadline (or "run-out"
period) for filing both medical expense and dependent care claims
incurred during the plan year, as well as medical expenses incurred
during the grace period, will be April 15, 2007.
Are you planning to retire in 2007?
If so, you may want to have your entire annual contribution amount
withheld from the number of checks you will receive in 2007 so you
can take advantage of the pretax benefit for the entire calendar
year. Contact Donna Weber (36-4323) for
assistance if necessary.
Faculty and Teaching Academic Staff only:
You must have your annual contribution withheld from nine checks.
ERA contributions are not taken out during the summer, even if you
are receiving paychecks during the summer.
Dentacare plans are offered under two separate contracts.
One is sponsored by UW System and the other is sponsored by the
Office of State Employment Relations (OSER).
October 9 - 27,
2006 is open enrollment period for both the UW System and
the Office of State Employment Relations (OSER) sponsored
DentalBlue Plans which includes Dentacare HMO, Dentacare PPO,
and the Supplemental Plan.
be effective January 1, 2007. To enroll in Dentacare,
employees must be eligible to enroll in the State of Wisconsin
group health insurance program with either an immediate or
future state share contribution.
If you are already
covered under any of the above plans, the annual change
opportunity also runs from October 9 - 27, 2006. During
this period you can add eligible dependents or change to a
different DentalBlue plan. Coverage changes will be
effective January 1, 2007.
Plan is available to anyone who already has some dental coverage
provided by their participating health plan.
UW System sponsored
non-represented classified staff (including LTE's covered by the
retirement system), and graduate assistants are eligible to enroll
for single, employee + 1 or family coverage. Rehired
annuitants are not eligible.
OSER sponsored plan:
classified employees are eligible for single, employee +1 or family
Important Note: The UW System and OSER plans are
virtually identical; however, represented employees must enroll in
the OSER sponsored plan.
Watch for more information coming soon.
for Health Insurance
If you have dependents who are
over 19 and are still covered under your health insurance plan,
insurance company will be mailing out Student Status forms.
They will arrive in your mail in late October, and are due back to
the health insurance company by December 1. It is
crucial to complete and submit the forms in a timely manner.
Coverage for your dependents could be jeopardized if you ignore the
form. Employees must submit the student status
information to their current insurance company, even if they
plan to change plans during the Dual Choice Enrollment period.
Your current company will forward the completed plans
Is my dependent child
covered in 2007?
Coverage for dependent
children who are not physically or mentally disabled terminates at
the earliest of the following dates:
The end of the month in which the child marries.
* The end of the calendar year in which the child
* Turns 19 while not a full-time student
* Ceases to be a full-time student and is age 19 or older
* Turns 25 while a full-time student
* Ceases to be dependent on either parent or guardian for
If you have a dependent who is no longer eligible for coverage in
2007 please contact the Office of Human Resources. We must remove
the dependent from your health insurance and offer continuation
benefits. The notification is not part of the dual choice enrollment
function, but rather a separate requirement.
Questions regarding Dual Choice may be directed to the Office of
Human Resources at 36-3871.